Left Lower Quad Pain

[torigd]

I am an overweight 42 yo female. I am not sure of what to think about my symptoms. Chronic weight gain even with dietary changes (40 lbs--1yr). For the last 6 mo I have been having (L)lower quad pain with occasional nausea no vomiting. It is not always associated with a BM. It is present before and or hours after a BM. At times the pain is enough to double me over. The pain can be off and on or all day. Standing, walking or sitting does not relieve the pain it generally increases the pain. I generally just tolerate the pain since nothing seems to ease it. Lately the pain is  up higher on my (L) side but also mid quad on my right side. I have problems with constipation so I take Fiber Con daily and try to drink plenty of water which has helped. My stool can be ribbon like at times followed by normal stool. Color can be tanish to normal. Diarrhea is not a problem. I do have problems with hemorrhoids occasionally. I also get fissures. The last episode was about 2mo ago. It lasted almost 2wks with horrible pain. Normally I do not have pain with BM. Due to childbirth I am told (GYN), I have to provide peri support to have a BM.

My past history includes most recently problems with chronic migraines requiring multiple meds to finally help alleviate them. They lasted 1 1/2 yrs on a daily basis. I am no longer on any meds except Magnesium for migraines. I had a reaction to Desyrel--Tachycardia that has never resolved. I take Topral now as a result to control the tachycardia. Cardiac work up normal-no explaination for tachycardia. I also have had ovarian cyst in the past--none currently. I have an IUD in place. Current meds include: Multivitamin, Flax Seed, Magnesium 1200mg, Aloe Vera, Lexapro 10mg, Topral 50mg, and Fiber Con. When I was 18-19 yr I had problems with diarrhea x3mo. Colonoscopy revealed 3 polyps upper sigmoid no reason for the diarrhea. No f/u recommended. My family hx is noted for grandfather with Colon CA and also his sister with Colon CA. Both are now deceased. Mother with Ovarian CA, father deceased due to ALL.

Any thoughts you would like to share? I have an appointment to see my doctor in 4 weeks.

[Kevin Pho, MD]

The colonoscopy would rule out most anatomical problems for the symptoms (i.e. mass, stricture etc.).  Regarding the chronic weight gain and constipation, I would check the tyroid level.  Hypothyroidism can cause both of these symptoms.  

More specialized testing, including a colonic marker study, defecography or pelvic floor studies can all be part of the constipation evaluation.

If the tests remain negative, irritable bowel syndrome can be considered - treatments like Zelnorm can be discussed.  

I would consider these options with your personal physician, or in conjunction with a GI evaluation.

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Kevin, M.D.
Medical Weblog:
kevinmd_b

[danad305]

A related discussion, LLQ pain was started.